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左西孟旦联合托拉塞米在扩张型心肌病心力衰竭患者中的治疗效果探究
作者:饶友义  杨敏  任琳  王宇  阎锡大 
单位:绵阳市中心医院 药剂科, 四川 绵阳 621000
关键词:左西孟旦 托拉塞米 扩张型心肌病 心力衰竭 疗效 
分类号:R541.6
出版年·卷·期(页码):2019·47·第三期(295-299)
摘要:

目的:探究左西孟旦联合托拉塞米在扩张型心肌病心力衰竭患者中的治疗价值。方法:以2016年5月至2018年5月我院收治的164例扩张型心肌病患者为研究对象,随机分为观察组(A组,82例)和对照组(B组,82例)。予B组常规药物辅以托拉塞米利尿治疗,在B组的所有用药基础上予A组加用左西孟旦治疗。比较分析两组6 min步行实验(6MWT)、左室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、血清肌钙蛋白I(cTnI)、N-末端前脑钠肽(NT-proBNP)等指标差异以及不良反应发生情况。结果:两组治疗后,心功能指标均得到显著改善。与B组相比,A组患者LVESD、LVEDD、cTnI、NT-proBNP水平明显降低(P<0.05),6MWT距离显著增加(P<0.05),LVEF显著升高(P<0.05);治疗过程中,B组不良反应种类及频率均显著高于A组(P<0.05)。结论:左西孟旦联合托拉塞米应用于扩张型心肌病心力衰竭患者疗效显著,同时对于降低不良反应的发生也有一定临床价值。

Objective:To investigate the curative effect of levosimendan combined with torsemide used in patients with heart failure caused by dilated cardiomyopathy. Methods:A total of 164 patients with heart failure caused by dilated cardiomyopathy admitted to our hospital from May 2016 to May 2018 were randomly divided into observation group (group A, 82 cases) and control group (group B, 82 cases). Both of the groups were treated with conventional drugs, and patients of group B was treated with torasemide. Base on that, patients of group A was treated with levosimendan. The analysis of two groups of six minute walk test(6 MWT), left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left ventricular end-diastolic diameter(LVEDD), serum troponin I (cTnI) and N-terminal pro-B-type natriuretic peptide(NT-proBNP), and adverse reactions were compared.Results:After treatment, the cardiac function indexes in both groups were significantly improved.Compared with group B, patients in group A showed significantly lower levels of LVESD, LVEDD, cTnI, NT-proBNP(P<0.05), 6MWT distance significantly increased(P<0.05), LVEF significantly increased(P<0.05).During the treatment, the type and frequency of adverse reactions in group B were significantly higher than those in group A(P<0.05). Conclusion:Levosimendan combined with torasemide is effective in heart failure patients caused by dilated cardiomyopathy, and has a certain clinical value in reducing the occurrence of adverse reactions.

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